Xiao Zhang, 25, was overweight due to not paying attention to weight control during pregnancy. Considering the risk of natural childbirth is difficult to control, the doctor advised her to have a cesarean section. With the support of her family, she also chose to have a cesarean section to avoid unnecessary risks.
However, what she did not expect was that this choice made her walk through the gates of hell.
Because the preoperative examinations were all right, the date of the surgery was decided quickly. In terms of anesthesia, in order to avoid the supine position syndrome, the anesthesiologist plans to use epidural, a slow-acting anesthesia method.
On the day of the operation, Xiao Zhang was lying on his side on the narrow operating table.
There is no way, the operating table can only be so narrow. If it is too wide, the doctor may not be able to miss the operating area.
Fortunately, the anesthesiologist was quick and quick, and the puncture was completed in a few minutes.
Laying on her back, she felt a chill on her back. The anesthesiologist comforted her: she gave her a little local anesthetic to test the effect.
At that time, she was still thinking: Is anesthesia still tested? What should I do if it doesn’t work?
I felt a chill again with nervousness and crankiness. I wanted to ask when the surgery would start, but soon I didn’t know anything.
Actually, at this time, the anesthesiologist had already tested that the epidural anesthesia should be safe, so he pushed in more than ten milliliters of local anesthetic.
However, a rare situation occurred: Shortly after pushing the drug, Xiao Zhang suddenly said of chest tightness, shortness of breath, and then his blood pressure dropped at a rate visible to the naked eye. At this time, Xiao Zhang was already confused. Asked her after the surgery, she couldn’t recall this episode.
Seeing a drop in blood pressure, the anesthesiologist immediately injects multiple vasopressors. Considering that Xiao Zhang’s breathing was not good, she was immediately intubated.
After nearly 30 minutes of rescue, Xiao Zhang’s spontaneous breathing finally came back.
At this point, it is uncertain whether the epidural is effective or not, but the child has to continue dissection. So, the anesthesiologist injected anesthesia into her vein.
Obstetricians delivered a baby boy after the anaesthetic took effect.
At the end of the operation, the perplexed anesthesiologist pulled the epidural catheter back while extubating it. No cerebrospinal fluid was found until it was all pulled out. Because in his opinion, only a total spinal anesthesia can cause such a serious situation.
On the second day, the Department of Anesthesiology organized a case discussion. After discussion, everyone agreed that this was a rare delayed general spinal anesthesia.
Delayed total spinal anesthesia, as the name suggests, is delayed. Compared with the “immediate onset” of the epidural experimental amount, the time of this delay is uncertain. Some appeared after ten minutes, and some appeared after dozens of minutes.
Because the delay is a case, the mechanism is not very clear at present. However, no matter what the reason is, as long as the patient experiences coma, dyspnea, or a drop in blood pressure, tracheal intubation should be performed in a timely manner, fluid infusion should be accelerated, and vasopressors should be applied to maintain the stability of the patient’s breathing and circulatory function.
Total spinal anesthesia is dangerous and affects the life safety of patients, but as long as it is diagnosed and treated in a timely manner, most patients can turn the corner.
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